American journal of rhinology & allergy
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Am J Rhinol Allergy · Mar 2015
Comparative StudyComparative analysis of quality-of-life metrics after endoscopic surgery for sinonasal neoplasms.
The objective of this study was to evaluate the postoperative quality of life (QOL) after endoscopic resection of sinus and skull base neoplasms using validated outcomes measures and to perform correlation of the various metrics to better discern their efficacy. Prospective QOL data collection and retrospective chart review were performed. ⋯ Patients who have undergone endoscopic resection of sinonasal tumors have quantifiable QOL changes as measured by various validated metrics. This study shows that concurrent use of these instruments may better discern QOL outcomes after endoscopic tumor surgery.
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Am J Rhinol Allergy · Mar 2015
ReviewThe blood-brain barrier and nasal drug delivery to the central nervous system.
The blood-brain barrier (BBB) is a highly efficient system that separates the central nervous system (CNS) from general circulation and promotes selective transport of molecules that are essential for brain function. However, it also limits the distribution of systemically administered therapeutics to the brain; therefore, there is a restricted number of drugs available for the treatment of brain disorders. Several drug-targeting strategies have been developed to attempt to bypass the BBB, but none has proved sufficiently effective in reaching the brain. ⋯ Despite extensive efforts to develop new techniques to cross the BBB, none has proved sufficiently effective in reaching the brain, whereas minimizing adverse effects and the endoscopic mucosal grafting technique offers new potential promise.
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Am J Rhinol Allergy · Jan 2015
Randomized Controlled Trial Multicenter Study Comparative StudySqueeze bottle versus saline spray after endoscopic sinus surgery for chronic rhinosinusitis: a pilot multicentre trial.
There is a need for controlled trials to guide the perioperative management of patients undergoing endoscopic sinus surgery (ESS). The authors performed a pilot multicenter trial to compare two types of saline delivery devices in this population. ⋯ In this pilot multicenter trial examining patients with chronic rhinosinusitis undergoing ESS, both squeeze bottle and saline spray showed significant improvement in SNOT-22, POSE, and NSS scores at one-month postoperatively. Because the study was nonpowered, we cannot rule out a potential difference between the two treatment groups.
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Am J Rhinol Allergy · Nov 2014
Allergic rhinitis phenotypes based on bronchial hyperreactivity to methacholine.
Allergic rhinitis (AR) and asthma may be associated, bronchial hyperreactivity (BHR) is quite common in AR patients. Methacholine (MCH) is a stimulus able to elicit BHR, as many other ones. Phenotyping AR is an up-to-date issue. ⋯ The present study demonstrates that BHR to MCH could define two distinct phenotypes in AR patients. It could be clinically relevant as BHR-positive patients have initial impairment of lung function, impaired FeNO values, and worsening of respiratory symptoms perception.
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This study was designed to determine the characteristics of medical negligence claims in rhinology. In 2010-2011 the National Health Service (NHS) litigation bill surpassed 1 billion Great British Pounds (GBP; 1.52 billion U.S. dollars [US$]). Systematic analysis of malpractice complaints allows for the identification of errors and can thereby improve patient safety and reduce the burden of litigation claims on health services. ⋯ This is the first study to report the outcomes of negligence claims in rhinology in the United Kingdom. Claims in rhinology are associated with a high success rate. Steps that can be taken to reduce litigation include careful patient workup and ensuring adequate informed consent. Where there is a suspicion of orbital damage early recognition and intervention is needed to reduce long-term injury to the patient.